Provider Demographics
NPI:1093959355
Name:RS NUCLEAR MEDICINE PC
Entity Type:Organization
Organization Name:RS NUCLEAR MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-686-0895
Mailing Address - Street 1:825 57TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3674
Mailing Address - Country:US
Mailing Address - Phone:718-686-0895
Mailing Address - Fax:347-751-3532
Practice Address - Street 1:825 57TH ST STE 103
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3674
Practice Address - Country:US
Practice Address - Phone:718-686-0895
Practice Address - Fax:347-751-3532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYH90 1187495 83261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02621612Medicaid
NY9N2421Medicare PIN
NY02621612Medicaid